Individual
THEODORE O EKONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3127 EASTWAY DR, STE. 109, CHARLOTTE, NC 28205-5643
(704) 536-5911
(704) 536-9770
Mailing address
3127 EASTWAY DR, STE. 109, CHARLOTTE, NC 28205-5643
(704) 536-5911
(704) 536-9770
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00651
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703516
—
NC
Enumeration date
04/19/2007
Last updated
07/09/2007
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